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See a sample rate comparisonHCPCS G2175 Fee Schedule
HCPCS G2175 is classified under Procedures / Professional Services, in the Clinician Documentation and Management Services subgroup.
Episodes where the patient had a comorbid condition during the 12 months prior to or on the episode date (e.g., tuberculosis, neutropenia, cystic fibrosis, chronic bronchitis, pulmonary edema, respiratory failure, rheumatoid lung disease)
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Clinician Documentation and Management Services |
| Complexity Level | Low |
National average reimbursement for HCPCS G2175 by major payers:
$71.25
BCBS / Anthem
$N/A
UnitedHealthcare
$49.42
Aetna
$0.00
Cigna
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HCPCS G2175
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See a sample payer proposalHCPCS G2175 vs. Other Clinician Documentation and Management Services Codes
The table lists codes related to G2175. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G2174-HCPCS | Low | Uri episodes where the patient is taking antibiotics (table 1) in the 30 days prior to the episode date |
| G2175-HCPCS | Low | Episodes where the patient had a comorbid condition during the 12 months prior to or on the episode date (e.g., tuberculosis, neutropenia, cystic fibrosis, chronic bronchitis, pulmonary edema, respiratory failure, rheumatoid lung disease) |
| G2176-HCPCS | Low | Outpatient, ed, or observation visits that result in an inpatient admission |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G2175. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G2175 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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